Your form message has been successfully sent.

You have entered the following data:

Class Registration Form

Please correct your input in the following fields:

Error while sending the form. Please try again later.

Parent or Gaurdians Name: *

Address: *

Home and Mobile number: *

E-mail address: *

Class or classes I am interested in: *

Student Name: *

Student Age and DOB:

Name of School or nursery: *

Does the student have any allergies or condition which requires medical treatment on a regular basis? please specify: *

Is there anything else we should be aware of?

I agree to my child receiving emergency medical treatment, including anaesthetic, as considered necessary by the medical authorities present.

Emergency Contact Name: *

Relationship to student: *

Home and Mobile number:

Promotional pictures and videos may be taken during LMPA classes and events; we will require a written request if you do not wish for your child to take part.

Captcha (spam protection code): *

I agree that my data entered in this form will be stored electronically by LMPA Academy and a hard copy will also be with class teacher where appropriate. I am aware that I can revoke my consent and also request to have my details deleted at any time.

Note: Fields marked with * are required

Contact LMPA

07763473886

Lorayne@LMPerformingArts.com

Or use our contact form

LMPA Facebook Page

Web View Mobile View

Logout Edit page